The 2018 midterm elections are less than two weeks away, and many polls show there is a sizable bloc of independent voters who have not yet made up their minds. At the same time, health care remains the No. 1 issue for the American people.

The best way for Republicans to earn the votes of these undecided voters – and honor commitments to the Republicans who already support them – is to clearly articulate how they would fix our broken health care system.

This is an example of what that plan should be. It could be titled: Republicans are creating a better health system and pledge to do more.


Republican principles for America’s health and health care system

1. We believe every American should have the opportunity to live a long and healthy life, supported by a health system that is simple to use, innovative and affordable.

2. We believe that every American should have his or her choice of doctors and insurance that meet his or her specific needs.

3. We believe the health system should be transparent about health-care costs and quality of treatments options, and that this information should be available to every American in a simple, understandable way so patients can make better decisions about their own health.

4. We believe in protecting patients with pre-existing conditions so that they can obtain affordable health insurance coverage

5. We believe in the importance of American medical innovation that leads to breakthroughs that dramatically improve health outcomes while significantly lowering costs.

6. We believe that the doctor-patient relationship is at the center of an effective health system, and it should not be disrupted by micromanagement from public and private bureaucracies.

7. We believe American seniors have earned their health care benefits; and that they, their families, and their doctors should make their own medical decisions – not unelected government boards, bureaucrats, or private third-party payers and middlemen.

8. We believe in a competitive health-care market where private sector innovation works to strengthen public programs. One-size-fits-all government-controlled health care interferes with doctor-patient relationships, kneecaps new medical breakthroughs, provides less access to treatments, and leads to long wait times for critical care.

9. We believe that the current health-care system in America is far too expensive. While it is very good at treating people when they become sick, it is much less effective at helping Americans remain healthy – which is equally as important.

10. We believe the goal of health reform should be to build on what’s working and fix what’s not. Destroying what’s good about our health system in an attempt to fix what’s bad is not an acceptable step toward a better future.

If the American people re-elect Republicans to a majority in the House and Senate, we pledge to enact a series of practical and specific changes, based on what works in the public and private sectors, to build a better health system.

Republican accomplishments in improving America’s health and health care system

Consistent with these principles, Republicans have taken several steps to improve the simplicity and affordability of America’s health and health-care system. So far, the Trump administration and the Republican-led Congress have:

1. Passed legislation to eliminate the ObamaCare individual mandate penalty.

2. Passed legislation to end pharmacy “gag” clauses so patients can find the lowest prices for drugs.

3. Passed Right-To-Try legislation.

4. Passed $6 billion in new funding to fight the opioid epidemic.

5. Passed the historic VA Mission Act, which replaced the troubled Veterans Choice Program and passed the VA Accountability and Whistleblower Protection Act to make sure Department of Veterans Affairs employees are held accountable for bad behavior and bad service.

6. The Trump administration is providing more affordable health-care options for Americans through association health plans and short-term limited-duration plans.

7. In the first year of the Trump administration, the Food and Drug Administration approved more affordable generic drugs than ever before in history. Thanks to its efforts, many drug companies are freezing or reversing planned price increases.

8. The Trump administration reformed the Medicare program to stop many hospitals from overcharging seniors on their drugs – saving seniors hundreds of millions of dollars this year alone.

9. The Trump administration cut high-dose opioid prescriptions by 16 percent during its first year in office. This year, President Trump signed the SUPPORT for Patients and Communities Act to direct even more resources to fighting addiction and crack down on dangerous synthetic drugs that are killing tens of thousands of Americans a year.

10. Under the Trump administration, the VA expanded telehealth services, walk-in clinics, same-day urgent primary and mental health care, and launched the promised 24-hour White House Department of Veterans Affairs Hotline.

Republican promises for additional improvements to America’s health and health-care system

If the American people re-elect Republicans to a majority in the House and Senate, we pledge to enact a series of practical and specific changes, based on what works in the public and private sectors, to build a better health system. This system will keep people healthy and provide effective treatments and economic security for those who get sick. These legislative changes will:

1. Protect patients with pre-existing conditions with an alternative approach to the Washington-knows-best method of ObamaCare, which doubled premiums in the individual marketplace. We will do so by committing the resources necessary for states to try new approaches, like high-risk pools and reinsurance, so everyone – regardless of medical history – has access to affordable insurance.

2, Further reduce the cost of prescription drugs by requiring additional transparency and accountability across the entire prescription drug supply chain (from manufacturers, to pharmacy benefit managers, to health insurers); making sure patients receive the benefits of drug manufacturer discounts and rebates; changing Food and Drug Administration rules to accelerate the release of new and generic drugs to market; and creating incentives to give more patients affordable access to new, highly-effective treatments that cure diseases and save money over time but have large up-front costs that create short-term challenges for public and private payers.

3. Lower premiums for individuals and small businesses by eliminating the health insurance tax; reducing Washington mandates that limit choices and drive up the cost of insurance; allowing the self-employed and small businesses to band together to purchase insurance so that they can have the same negotiating power as big businesses; and making it easier for smaller companies to self-insure.

4. Strengthen Medicare by protecting Medicare Part D patients from excessive out-of-pocket costs for drugs; protecting the market competition model of Medicare Part D, which has kept premiums low for seniors; eliminating unelected boards and bureaucrats that have decisions over treatments; and protecting Medicare as a program for seniors by opposing government-run health care, which would strain resources and limit availability and access to health services.

5. Maximize medical innovation by fully funding National Institutes of Health research that leads to new cures and treatments; creating incentives for private sector research dollars to flow into national health priorities, such as Alzheimer’s disease; repealing the medical device tax; reforming the FDA to give patients access to breakthrough treatments faster and at lower costs; and applying pressure on foreign countries to pay their fair shares for U.S.-developed drugs.

6. Make health-care simpler by passing additional legislation to make the price and quality of health care providers visible and useful to patients; insisting on patient rights to ownership and portability of their medical records; liberating primary care physicians to practice their craft with minimal interference from government and insurer bureaucracies – including expanding patient access to direct primary care options; and reducing or modifying federal mandates, which increase administrative overhead, incentivize waste, and interfere with the kind of doctor-patient relationship that keeps people healthy for the long term.

7. Fight the opioid crisis by reducing the use of opioids to treat pain; enhancing border security to stop the flow of deadly fentanyl into our communities; investing in research to create non-addictive painkillers; and improving access to evidence-based treatment – including medication-assisted treatment.

8. Address the underlying costs of health care by focusing on treating chronic disease; shifting to payment models based on value and long-term health outcomes; passing medical liability reform to reduce unnecessary and duplicative testing; fighting health-care fraud through public and private investment in information technology that the credit card industry uses successfully; and emphasizing public investment in improving the social determinants of health status, such as access to public transportation, affordable housing and healthy food options.

This is the type of Contract on Health that Republicans should be willing to sign – and deliver – to the American people so that we can all live longer, healthier, more productive and more enjoyable lives.